Ketone monoester ingestion improves endothelial function during hyperglycemia in females with polycystic ovary syndrome.
Level 2 - randomized trial
Randomized, double-blind, placebo-controlled crossover trial
PubMed 41494652 · doi:10.1152/ajpendo.00453.2025
What was done
Ten females with polycystic ovary syndrome (PCOS; age 27 ± 5 years, BMI 23.8 ± 2.7 kg/m²) and 10 age- and BMI-matched controls (age 27 ± 4 years, BMI 23.7 ± 2.0 kg/m²) completed a randomized, double-blind, placebo-controlled crossover trial. After an overnight fast, participants ingested a ketone monoester (KME; 482 mg/kg) or a taste-matched placebo 30 minutes prior to a 75-g oral glucose tolerance test (OGTT). Endothelial function was assessed via brachial artery flow-mediated dilation (%FMD) at baseline and at 0, 60, and 120 minutes post-glucose bolus.
What was found
Following placebo, overall %FMD was lower in PCOS than in controls (P < 0.01). %FMD significantly decreased from baseline to 60 minutes post-glucose in both groups (PCOS: 6.3 ± 0.4% to 4.2 ± 0.4%, P < 0.01; controls: 9.7 ± 0.9% to 6.6 ± 0.9%, P < 0.01). The impairment remained sustained at 120 minutes only in PCOS (6.3 ± 0.4% baseline vs. 4.0 ± 0.5% at 120 min, P < 0.01). In both groups, pre-treatment with KME significantly decreased plasma glucose area under the curve (P < 0.01) and improved %FMD across the OGTT (P < 0.01).
Why it matters
This study demonstrates that young, normal-weight females with PCOS experience prolonged acute endothelial dysfunction following a glucose challenge, and that acute exogenous ketone supplementation can mitigate both postprandial hyperglycemia and vascular impairment.
Limits
The sample size was small (n = 10 per group). The study evaluated only acute, single-dose responses in young, normal-weight females; chronic efficacy, tolerability, and long-term cardiovascular outcomes were not evaluated.
Cited by
- partial A clinical study in women with polycystic ovary syndrome (PCOS) demonstrated that exogenous ketone supplementation improved metabolic markers and clinical outcomes of PCOS as a standalone intervention.